11D2034396 CLIA NUMBER - WALGREENS 12262

Laboratory Demographics

  • CLIA Code: 11D2034396
  • Facility Name: WALGREENS 12262
  • Facility Address: 2320 N DRUID HILLS ROAD, NE
    ATLANTA, GA
    ZIP 30329
  • Facility Phone: 404 248-1793
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RAVIKANTH PASALA
  • NPI Number: 1609104702
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2034396
LAB Type Pharmacy
Facility Name WALGREENS 12262
Street 2320 N DRUID HILLS ROAD, NE
City ATLANTA
State GA
ZIP 30329
Phone 404 248-1793
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/17/2025
Certificate Expiration Date 8/16/2027
Facility Type Pharmacy
Lab Director RAVIKANTH PASALA

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This page was last updated on: 9/29/2025